<form id='form_step4' method='post' action='<?php echo site_url("user/create_account/save/4")?>' onsubmit="return Send('#form_step4');">
	<table id="form4_container1_tbl" cellspacing='0' cellpadding='0' width="100%">
		<tr>
			<td colspan='4'>
				<div class='lbackground'></div>
					<div class='header_center'>
						Provide Employment Information for Primary Account Holder:
						<div class='rbackground'></div>
				</div>
			</td>
		</tr>
		<tr>
			<td><label id='employmentStatusLbl' for='employmentStatus'>Employment
					Status:*</label>
			</td>
			<td><select id='employmentStatus' name='employmentStatus'>
					<option value=''>Select One</option>
					<option value='Employed'>Employed</option>
					<option value='Self-Employed'>Self-Employed</option>
					<option value='Retired'>Retired</option>
					<option value='Student/Homemaker'>Student/Homemaker</option>
					<option value='Unemployed'>Unemployed</option>
			</select>
			</td>
		</tr>
	</table>
	<div id='space'></div>
	<div id='emplyment_details'>
		<table id="form4_container2_tbl" cellspacing='0' cellpadding='0' width="100%">
			<tr>
				<td colspan='4'>
					<div class='lbackground'></div>
					<div class='header_center'>
						Employment Details:
						<div class='rbackground'></div>
					</div>
				</td>
			</tr>
			<tr>
				<td><label id='employerNameLbl' for='employerName'>Employer's Name:*</label>
				</td>
				<td colspan="3"><input type='text' id='employerName' name='employerName'
					size='20'></input>
				</td>
			</tr>
			<tr>
				<td><label id='employerCountryLbl' for='employerCountry'>Country:*</label>
				</td>
				<td colspan="3"><select id='employerCountry' name='employerCountry'>
						<option value=''>Select One</option>
						<option value=''>------------</option>
						<?php foreach($countries as $item){?>
						<option value='<?php print $item->ID; ?>'>
						<?php print $item->NAME; ?>
						</option>
						<?php }?>
				</select>
				</td>
			</tr>
			<tr>
				<td><label for='addressLine1Empl' id='addressLine1EmplLbl'>Address
						line 1:*</label>
				</td>
				<td colspan='3'><input name='addressLine1Empl' type='text' size='45' class="longInput"></input>
				</td>
			</tr>

			<tr>
				<td><label for='addressLine2Empl' id='addressLine2EmplLbl'>Address
						line 2:</label>
				</td>
				<td colspan='3'><input name='addressLine2Empl' type='text' size='45' class="longInput"></input>
				</td>
			</tr>

			<tr>
				<td><label for='cityEmpl' id='cityEmplLbl'>City/Town:*</label>
				</td>
				<td><input name='cityEmpl' type='text' size='20'></input>
				</td>
				<td><label for='regionEmpl' id='regionEmplLbl'>County/State:</label>
				</td>
				<td><input name='regionEmpl' type='text' size='20'></input>
				</td>
			</tr>

			<tr>
				<td><label for='pCodeEmpl' id='pCodeEmplLbl'>Postal Code:</label>
				</td>
				<td colspan="3"><input name='pCodeEmpl' type='text' size='20'></input>
				</td>
			</tr>

			<tr>
				<td><label for='businessNature' id='businessNatureLbl'>Nature of
						Business:*</label>
				</td>
				<td><input name='businessNature' type='text' size='20'></input>
				</td>
				<td><label for='positionEmpl' id='positionEmplLbl'>Position held:*</label>
				</td>
				<td><input name='positionEmpl' type='text' size='20'></input>
				</td>
			</tr>

			<tr>
				<td colspan='4'><label for='' id='overseasRegulatorLbl'>Do you work
						for a firm or branch regulated by the FSA or by an overseas
						regulator?* </label> <br /> <input type='radio'
					name='overseasRegulator' id='overseasRegulatorYes' value='1'></input>
					<label for='overseasRegulatorYes' id='overseasRegulatorYesLbl'>Yes</label>

					<input type='radio' name='overseasRegulator'
					id='overseasRegulatorNo' value='0'></input> <label
					for='overseasRegulatorNo' id='overseasRegulatorNoLbl'>No</label>
				</td>
			</tr>
		</table>



	</div>
	<div id='space'></div>

	<table id="form4_container3_tbl" cellspacing='0' cellpadding='0' width="100%">
		<tr>
			<td colspan='4'>
				<div class='lbackground'></div>
					<div class='header_center'>
						Financial Information for Primary account holder:
						<div class='rbackground'></div>
				</div>
			</td>
		</tr>
		<tr>
			<td><label id='anualIncomeLbl' for='anualIncome'>Approx. annual
					income before tax:* </label>
			</td>
			<td><select id='anualIncome' name='anualIncome'>
					<option value=''>Select One</option>
					<option value='1'>Less than $25,000</option>
					<option value='2'>$25,000 - $49,999</option>
					<option value='3'>$50,000 - $99,999</option>
					<option value='4'>$100,000 - $199,999</option>
					<option value='5'>$200,000 +</option>
			</select>
			</td>
		</tr>

		<tr>
			<td><label id='savingInvestLbl' for='savingInvest'>Approx. value of
					saving and investments:* </label>
			</td>
			<td><select id='savingInvest' name='savingInvest'>
					<option value=''>Select One</option>
					<option value='1'>Less than $10,000</option>
					<option value='2'>$10,000 - $24,999</option>
					<option value='3'>$25,000 - $49,999</option>
					<option value='4'>$50,000 - $99,999</option>
					<option value='5'>$100,000 - $499,000</option>
					<option value='6'>$500,000 - $999,000</option>
					<option value='7'>$1,000,000 +</option>
			</select>
			</td>
		</tr>

		<tr>
			<td colspan="2">
				<label id='foundSourceLbl' >
					Sources of these funds (Please select at least one):* 
				</label> 
				<br /> 
				<input type='checkbox' id='foundSourceEmpl' name='foundSource[]' value='1'></input> 
				<label id='foundSourceEmplLbl' for='foundSourceEmpl'>Employment</label> 
				
				<input type='checkbox' id='foundSourceInherit' name='foundSource[]' value='2'></input> 
				<label id='foundSourceInheritLbl' for='foundSourceInherit'>Inheritance</label>
				 
				<input type='checkbox' id='foundSourceInvest' name='foundSource[]' value='3'></input> 
				<label id='foundSourceInvestLbl' for='foundSourceInvest'>Investments</label>

				<input type='checkbox' id='foundSourceOther' name='foundSource[]' value='4'></input> 
				<label id='foundSourceOtherLbl' for='foundSourceOther'>Other</label>

				<div id='other_found_source'>
					<label id='foundSourceOtherValLbl' for='foundSourceOtherVal'>Othersource:</label> 
					<input type='text' id='foundSourceOtherVal' name='foundSourceOtherVal' size='20'></input>
				</div>
			</td>
		</tr>

		<tr>
			<td>
				<label id='availableFtypeLbl' for='availableFtype'>Approx. amount of funds available for trading with us:* </label>
			</td>
			<td><select id='availableFtype' name='availableFtype'>
					<option value=''>Select One</option>
					<?php foreach($available_funds_type as $item){?>
					<option value='<?php print $item->ID; ?>'>
					<?php print $item->TYPE; ?>
					</option>
					<?php }?>
			</select>
			</td>
		</tr>

		<tr>
			<td><label id='propertyOwnerYesLbl' for='propertyOwnerYes'>Do you own
					property?* </label>
			</td>
			<td><input type='radio' id='propertyOwnerYes' name='propertyOwner'
				value='1'></input> <label id='propertyOwnerYesLbl'
				for='propertyOwnerYes'>Yes</label> <input type='radio'
				id='propertyOwnerNo' name='propertyOwner' value='0'></input> <label
				id='propertyOwnerNoLbl' for='propertyOwnerNo'>No</label>
			</td>
		</tr>

		<tr id='property_value'>
			<td><label id='propertyValueLbl' for='propertyValue'>Approx. value of
					property (Less mortgage)($):* </label>
			</td>
			<td><input type='text' id='propertyValue' name='propertyValue'
				size='20'></input>
			</td>
		</tr>


	</table>

	<div id='space'></div>

	<div id='submit_section' style='text-align: center;'>
		<input type='submit' value='Save & Continue' title='Save the form and continue to the next step' />
	</div>
</form>
